ONC Video: It’s time healthcare caught up with the way we live the rest of our lives

I’ve been in healthcare for awhile, yet must admit that a lot of information packaged for patients/consumers is pretty dry and not too creative. Content, often developed by health professionals or educators, can be medical-heavy and design-light. My litmus test when when I see something is simple. Can I figure out what it’s about? Is it relevant to peoples’ lives? If more than a sentence, does it hold my attention? All 3 criteria must be met, or, fuggedaboutit. Anything more – humor or cool design – gets extra points.

My doctor said she gave up on EMRs, they are so bad and do not help at all with patients, they are just checkboxes and clicks. There are so many third parties between us and our doctors, and ONC is unfortunately one of them. Those well meaning rules for reporting on various criteria did not translate very well in reality and everyone is deriding “meaningful use” (http://more-distractible.org/2012/06/11/a-funny-thing-happened-on-the-way-to-meaningful-use/ )

I had to put away my SPM seal printout and leave it for another day and another doctor. I don’t have access to my test labs and my data, my doctors don’t communicate electronically… all I can do is wish that I will be healthy while all this plays out.

How do we find the way? How can we help, how can we streamline all this mess for most of the patients and doctors in this country?

Ileana,
I agree we are on a bumpy road, with challenges from incentives for meaningful use. Such issues transcend electronic records, however. My provider performance pay focuses on lab tests and more lab tests. If you focus on A (tests and treatments), it’s hard to focus on B – like making sure all the patient’s agenda is addressed, communication is understood and all questions are answered. While ONC wants big reach of electronic records ( a must for consumer & family access to all their health information), it’s good they also have an effort to spur consumers to want it and bring it up. Research shows lack of access to information and services such as secure email can lead patients to vote with their feet. Here’s where taking the lead from Pharma (drug companies) — promotion through clinicians and direct to consumer advertising is a good idea. It obviously works :-)

This actually explains why my independent doctor that helps install her own EMR is doing so much better than the doctors that are associated with big hospital systems.

For meds, the doctor has the prescription pad, so if I ask for Z and the doc is pressed for time, he/she will find that writing that prescription is the most convenient way out.

If I ask my hospital associated doctor for my data , she will point to the awful hospital system. I do not have a direct relationship to the hospital administration, they just squeeze both me and my doctor to do what they want us to do.

Of course there are fewer and fewer independent physicians where the philosophy of having the consumer demand their data would work because we squeezed everything we could out of them: time and money.

This is perhaps a chance for me to give props to my long-time provider, Kaiser Permanente. I’ve been a member of Kaiser for about 30 years so that leaves me with little other reference point when it comes to health IT. I’m rather aghast to see all the comments indicating to me that decent IT systems are still the exception rather than the rule among medical practices and hospitals.

Kaiser offers an internal e-mail system to physicians, complete online records about all visits, tests and procedures, online appointments and drug refills, a decent online database of health and drug information, and online health courses. Now, of course, there’s an app for that.

Fortunately I’ve been healthy and have not had to utilize the system to its fullest, but my wife recently had an experience that made us very pleased with the way the Kaiser online system works. She had a spell of pulmonary embolism. When she saw her doctor with shortness of breath and elevated heart rate she was whisked off to the ER on the other side of Portland. There she was put through a series of standard blood tests that didn’t reveal much, but finally the ER doctor ordered a CT scan that showed blood clots in both lungs. She was admitted to the hospital for two days and started on blood thinners. Since her release she has had frequent blood draws and analyses to regulate her dosage of warfarin. She has been counseled by a special pharmaceutical team and now an ongoing nursing team.

What most impressed us was how how her records became the basis of a well-coordinated treatment system. Everybody had real-time access to the records (including my wife) and everyone involved seemed to be aware of all that was happening. Everybody was “on the same page,” as they say. The communications were frequent and constructive.

I’m sure there will be more improvement to the Kaiser system, but as I hear about the problems most people have, I appreciate it more.